11 and 17 March 2015
During a routine inspection
Longworth House Nursing Home is a semi-detached property in a residential area close to the centre of Eastbourne. It provides care and support for up to 20 older people with nursing needs. The care needs of people varied, some people had more complex health care needs including end of life care. Others had minimal nursing needs that were associated with increasing physical fragility and medical conditions that were managed with support and close monitoring of people’s health, including diabetes. Some people had limited mobility and were assisted with moving and others had additional needs associated with dementia. The home provided respite care for people wanting short stays in a nursing home. At the time of this inspection 16 people were living at the home.
This inspection took place 11 and 17 March 2015 and was unannounced.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.
The registered manager had told the provider they were unable to remain as the manager. A replacement manager had not been appointed. Due to staff vacancies the registered manager had recently had minimal management hours to undertake her management role.This reduction did not ensure the manager had adequate time to ovesee all areas of quality and safety. The provider had agreed to provide at least 30 hours management time for the registered manager as part of the registration process.
Some aspects of the home were not safe. Environmental risk assessments did not ensure all risks were identified and responded to effectively. This meant people may be exposed to risks like hot water or hot piping. Medicines were stored, administered and disposed of safely by staff who were suitably trained. However, guidelines and records relating to PRN and topical creams were not always clear and could mean that medicines were not given in a consistent way.
Feedback received from people and their representatives through the inspection process was positive about the care, the approach of the staff and atmosphere in the home. Communication was a key area that the registered manager had focussed on people and staff had benefitted from this open and positive culture.
Recruitment records showed there were systems in place to ensure staff were suitable to work at the home. Staff had a clear understanding of the procedures in place to safeguard people from abuse.
Staff were provided with a full induction and training programme which supported them to meet the needs of people. Staffing arrangements ensured staff worked in such numbers, with the appropriate skills that people’s needs could be met in a timely and safe fashion. The registered nurses attended additional training to update and ensure their nursing competency.
Staff knew and understood people’s care needs well and there were systems in place for all staff to share information. The care documentation supported staff with clear guidelines and reference to people’s choices and preferences. This ensured staff responded to people on an individual basis.
The registered manager understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Relevant guidelines were available within the nursing home for all staff to reference. Staff at all levels had an understanding of consent and caring for people without imposing any restrictions.
People were complementary about the food and the choices available. Mealtimes were unrushed and people were assisted according to their need. Staff monitored people’s nutritional needs and responded to them.
People had access to health care professionals when needed. Staff supported people and their relatives to ensure this access was well used and appropriate. A healthcare professional told us staff referred people to them appropriately and followed their advice and guidance to promote good health and nursing care.
There was a variety of activity and opportunity for interaction taking place in the nursing home. This took account of people’s physical and mental limitations and were based on what people enjoyed. Visitors told us they were warmly welcomed and felt they could come to the nursing home at any reasonable time.
People were given information on how to make a complaint and said they were comfortable to raise a concern or complaint if need be. A complaints procedure was readily available for people to use.
Feedback was regularly sought from people, relatives and staff. Staff meetings were being held on a regular basis this along with constructive handover meetings enabled staff to be involved in decisions relating to the home and people’s care. People were encouraged to share their views on a daily basis and satisfaction surveys were being used.